HomeMy WebLinkAbout10001 Adams Ave - CofOCERTIFICATE OF OCCUPANCY
CITY OF HUNTINGTON BEACH
Date
Address
District
06� —.-:j 9 2 9
Business Name
Tel.
R USTA tj RA111
Business Type
Occ. Group
BUILDING OWNER
BUSiNESS OWNERIMANAGER
�7
Name
Name
N. oAllbuf'.
Home
Address
Address
i NA G L N
I 1i T'l
4 — Home
City
Tel.
— City Tel.
Construction
No. of Stories
Occupant Load —,— Sprinklers --
CONDITIONS OF APPROVAL
This Certificate of Occupancy
SHALL BE posted in a conspicuous place on the
premises and shall not be removed wc, -)t by the
Building Official.
DEPARTMENT OF COMMUNITY DEVELOPMENT
COMMUNITY kE-
J LOPMENT
I
11�
/d APPLICATiON FUR CERTIFICATE OF OCCUPANCYLra
CITY OF HUNTINGTON BEACH
HurrrnCroN eFnal
DEPARTMENT OF COMMUNITY DEVELOPME T/
DATE
(PRINT OR TYPE ONLY) DA
`
Address
(pis
Business Name
r t t t L L-`� �9
bh�Q
Tel.
Business Type
FRs7 f=00 D 2a371A-LWf A_/V T
Occ. Group
BUILDING OWNER
BUSINESS OWNER/MANAGER
�--
�2 / 1�,2/Cj�fl� 1't 1' hJ-f T/�E
Name
�'
_
Home
-
1� ,�
�t
Address
Address
/ 1lA211 op- � �
City Gam'
T517j -579i�
!2GQ
%TNP, It d`( Home Te1.77 `7�
THIS USE WOULD BE DESCRIBED AS:
❑ EWLY CONSTRUCTED BLDG
EXISTING BUILDING
Indicate former use, if any
SQUARE FT. OF BUILD NG TO BE OCCUPI
CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
s Fn-.
Occupancy Gr. '�:) Div
NOTICE: 1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
inspected and a certificate of occupancy is issued.
2. No electrical service will be released for any existing building until the service has been inspected and
certified sate. All ap, licants for occupancy in an existing building are required to -schedule an electrical
'fuse up' inspection in the Department of Community Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building or
premises in order to determine if a change may be made in the character of occupancy or use of the building
or premises which would place the building in a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of shall
O be paid to the city.
[� 4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum of four (4)
tJ) inches in height with one half (1/2) inch stroke, and of a contrasting color from the background. These
numbers must be posted on your building in a location that is visible from the street.
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection and distribution per the
National Fire Protection Association pamphlet 1(0 (see reverse sidle).).
TRAFFIC IMPACT FEE C 40 Gln elf CNl /41l -7 —/? jl
DAT.: PAID (U) `
AMOUNT REC E
�v V, n
NAME
—
(FOR OFFICE USE ONLY)
SUPPLEME NFORMATION
ZONING
OCCUPANCY GROUP `-
`�
PLAN CHECK NO,
NO PARKING SPACES
OCCUPANT"LOAD
PERMIT NO.
HEALTH DEPT APPROVAL
NO. OF STORIES
ADMIN. ACTION
UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE
$
APPROVED
D E
CHANGE OF USE OR OCCUPANCY FEE $
TOTAL
I `
75.039 Rev. 11190 COMMUNITY DEVELOPMENT
I APPLICATION. FOR CERTIFICATE OF OCCUP/�'
I
CITY OF HUNTINGTON BEACH .
Nunm»crorr i w. DEPARTMENT OF COMMUNITY DtcUELOPMENr'�- %�-5" y� _
- (PRINT OR TYPE ONLY)- i"' DATE
JCC) i DAMS IIUAJTINGTciv 1r- /}c'i-t
Address ,�j District
Business Name F y +q 1 L -1 S � Tel 7 i �>' - `� bs - _7 9 a5 j
Business Type FT (Cl�D �r_TI�Ef(c+itiy h ,. "`ti
--� ' ; �OccGtoup•
BUILDING OWNER s BUSINESS OWNERIMANAGER
Name -.- key c - i.� r'1 L �t� Name - IC LC A f fi' E7Iv'f a iv E _
Home
Address ��c5J it •A.f�¢. , r Address iaC0 jlt 1A,28G2 tf3 �j
_V
City —Te 14071`1 S'�� iy NA ji E. , ri Home Tel.!
THIS USE WOULD BE DESCRIBED AS:
(❑ NEWLY CONSTRUCTED BLDG. CHANGE OF OWNER ❑ CHANGE OF OCCUPANT
L�J EXISTING BUILDING ❑ CHANGE OF USE ❑ ADDITIONAL OCCUPANT
Indicate former use, if any ng Occupancy Gr. = Div. `2
' SOUARE FT. OF BUILDING TO BE OCCUPIED
'Fro
NOTICE:
4
1. Occupancy of any building is prohibited and a business license will not be issued until the building has been
x ifspected-and ;certificate of.;ocCupancy:is;issued.
2. No electrical service will be released for any ex'sting building until the service has been inspected and
certified safe. All applicants for occupancy in ar existing building are required to schedule an electrical
'fuse up' inspection in the Department of Commt nity Development at the time this application is filed.
3. Change of occupancy or use inspection fee. Whenever it is necessary to make inspection of a building O"r
premises in order to determine if a change maybe made in the characterof occupancy or use ofthe building
or premises which would place the building in a different division of the same group of occupancy or in a
different group of occupancy, a change of occupancy inspection fee of $ — shall
be paid to the city. 1
4. Huntington Beach Fire Code Section 10.208 requires that building numbers must be a minimum. ul -...6r (4)
inches in height with one half (1/2) inch stroxe, and of a contrasting color from the background. These,
numbers must be posted on your building in a location that is visible from the street
5. Huntington Beach Fire Code Section 10.301 requires fire extinguisher selection.and distribution per the
National Fire Protection Association pamphlet 10 (see reverse side).
AlItIllf-
4vo
SUPP:.EME TA NFORMATION
OCCUP'ANCY GROUP
OCCUPANT LOAD
NO. OF STORIES
APPROVED . DATE
j 75-039 Rev. 11/90
r.
(FOR OFFICE USE ONLY)
4-C C �lk fnG
ZONING ( C !
PLAN CHECK NO, NO PARKING SPACES
PERMIT NO. HEALTH DEPT APPROVAL
ADMIN. ACTION -'.UTILITIES RELEASED
CERTIFICATE OF OCCUPANCY FEE
CHANGE OF USE OR OCCUPANCY FEE $
TOTAL $
FIRE
1
1
SUPPLEMENTAL INFORMATION
1. 130SINESS ADDRESS % X',C1(
1`lVI+M c /4 yr
2. Ferson to contact in case of
emergency. ni )-,& Lfny
Telephone number:
-I -I - '7 7 `�_ y 7 9b
x /S 66
3. Does the building in question
have electricity?
Yes
❑ No
(a) If Nc, are you requesting
that the electricity be
❑ Yes
turned on?
❑ No
4. The building is sprinklered?
_
❑ Yes
❑ No
5. Operations will produce dust/wood shavings or similar
material?
❑ Yes
No
6. Operations will involve the repair
or replacement of
❑ Yes
automobile parts?
1A No
If Yes:
(a) Describe the components
repaired or replaced.
(b) Does the operation involve the use of an open flame.? ❑ Yes
,M' No
7. The business is drinking, dining or assembly use that will
result in an occupant load of more than 50 persons. ❑rYes
0
8. The following best describes my operation;
Office Only
etaiI Sale
House
Manufacturing / Distribution (describe process and end product)
�3il� Denta
Oi:hel (describe)
SUPPLEMENTAL INFORMATION
SUPPLEMENTAL INFORMATION (Continued)
i
Does the operation involve any of the following materials? ❑ Yes
XNo
It Yes, indicate quantities:
Material Quantity
I
1. Flammable liquids
Class I -A
Class I-B
Class I-C
2. Combustible liquids
Class II
Class I11-A
3. Combination flammable liquids
4. Flammable gases
5. Liquefied flammable gases
6 FI
ammab a
fibers - loose
7.
Flammable
fibers - baled
8.
Flammable
solids
9.
Unstable materials
10.
Corrosive
liquids f
11.
Oxidizing
material - gases
12.
Oxidizing
material - liquids
13.
Oxidizing
material - solids
14. Orpa�peroxides
15. Nit ,iethane (unstable materials)
16. Ammonium nitrate
17. Ammonium nitrate compound mixtures
containing more than 60% nitrate
by weight
18. Highly toxic material and I'
poisonous gas
19. Smokeiess p,-wder
20. Black sporting powder
I hereby certify that the above information is true and correct to !
the best of my knowledge. I
cl
Signature Date
i
i
r
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-2000
Company Name:
Location of Ppoperty:
City: /fir 2t' — SL
AIR QUALITY ]PEWSIT CHECKLIST
for nonresi eennt' Al buildi, gs onIY
Zip Code:_ Zl �e_
Contact Person: //�%/ Title:
Telephone Numb '7 % %—.5 `% Fax Number:
Type of IndustryBusiness:
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
YES
NO
1.
Will the facility have a charbroiler? [ ]
[A
2.
Will any internal combustion engine with greater than 50 horsepower
operate at the facility (excluding motor vehicles)? [ ]
[]
3.
Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings?
4.
Will dust or smoke be generated at the facility? ]
5.
Will refining of any liquids or solids be done at the facility? [ ]
[
6.
Will any plating or coating of materials be done at the facility? [ ]
[
7.
Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility? [
[)fJ
8.
Will any acids, solvents, or motor fuel be used or stored at the facility?
9.
Will any organic liquids or gases be reacted or produced? [ ]
[
10.
Will any ovens be used to dry or cure products at the facility? [ J
[
11.
Will any CFC (Freon) recycling machines operate at the facility?
Applicant: T (&N E-- /t U jJ7o 0 r..i Signature: 00.L0_.c_
(Print name clearly)
If you have marked "NO" in all the boxes, an air quality permit is not needed at this ti.
and this checklist is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air Quality
Management District (AQMD). Please read the requirements on the back of the checklist.
(800) 389-••2121
in
ti
r
South Coast
AIR QUALITY MANAGEMENT DISTRICT
21865 E. Copley Drive Diamond Bar, CA 91765-4182 (909) 396-2000
Company r:ame: —
Location of Property:
AIR QUALITY PEW SIT CH?ECKLIST
for nonresi ent' 1 buildipgs oniv
/G0o% ,dam
City: � �r� � -�—� + � Zip Code: /5�L ce 5'�
Contact Person: //� %/ t Title:
Telephone Numb -7 % % i 9 Fax Number:
Type of IndustryBusiness:
To apply for a nonresidential building permit, you must complete this checklist. If you have any
questions about completing this checklist, please call (800) 388-2121.
YES
NO
1.
Will the facility have a charbroiler? [ ]
F/oQ
2.
Will any internal combustion engine with greater than 50 horsepower
operate at the facility (excluding motor vehicles)? [ )
0A
3.
Will operations at the facility involve mixing, blending, or processing of
solvents, adhesives, paints or coatings?
4.
Will dust or smoke be generated at the facility? [ ]
5.
Will refining of any liquids or solids be done at the facility? [ )
[
6.
Will any plating or coating of materials be done at the facility? [ ]
[
7.
Will any combustion equipment rated greater than 2,000,000 BTU/hr be
operated at the facility?
8.
Will any acids, solvents, or motor fuel be used or stored at the facility?
9.
Will any organic liquids or gases be reacted or produced? [ ]
[
10.
Will any oven_: be used to dry or cure products at the facility?
11.
Will any CFC (Freon) recycling machines operate at the facility?
Applicant:
cl/rA-N E !-t to iQ1—a o i,J Signature:
(Prim name clearly)
If you have marked "NO" in all the boxes, an air quality permit is not needed at this ti. ,
and this checklist is your written release.
If you marked "YES" in any of the boxes, you must contact the South Coast Air Quality
Management District (AQMD). Please read the requirements on the back of the checklist.
(800) 388-2121
f
J
NOTICE OF REQUIREMENTS
GOVERNMENT CODE SECTION 65850.2 (.AB3205)
California State Law (Government Code 65850.2) prohibits the Building Departments from
issuing a final certificate of occupancy unless all requirements of local air quality agency are
met. All applicants arc required to complete the air quality permit checklist. The checklist is
designed to aid the applicant for a nonresidential building permit only. If the answer to any of
the questions is "YES," the Building Department must obtain a written release from the local air
quality agency verifying that the applicant is in compliance.
1. All nonresidential building permit applicants must complete this checklist.
2. If the answers to all questions are "NO," the Building Department can accept the checklist
as the written release.
3. If any questions are answered "YES," the applicant must contact the AQMD by calling
(900) 388-2121 to determine whether air quality permits are required for any equipment
which may be operated at the site. If the AQMD determines that air quality permits are
not required or that all requirements have been met, a written release will be issued.
4. If air quality permits are required and applications have not been submitted, the applicant
must submit the necessary permit application(s) and appropriate fees before a written
release will be issued.
AQMD is committed to expediting all clearance letter requests. However, it may take several
weeks to verify compliance with all regturoments. Therefore, you are advised to contact AQMD
immediately after applying for b,0ding permits.
revised 8/95
(800' 88-2121
2
n
r
Government Code Section 65850.2(b) requires that the City of Huntington Beach not issue the final
certificate of occupancy unless the applicant has met or is meeting the requirements of the South
Coast Air Quality Management District (AQMD). The Department of Community Development must
obtain a written release from AQMD to show the applicant has compiled with this law. The check
list on the reverse side is designed to help the applicant and the building division to meet these
requirements.
1. The applicant (the sars,e person who applies for permits from the
Pepartment of Community Development) must complete the check list
which can be obtained either from the Department of Community
Development or at AQMD.
2. If all boxes in the list are checked "no", the Building Division can accept the
check list as the release.
3. If there are any "yes" answers in the list, the applicant must contact an
AQMD engineer by calling (714j 396-2000 to find out whether air permits are
required for the proposed construction project.
4. If air permits are not required, the applicant will obtain a written release from
AQMD.
5. If air ;permits are required, the applicant must submit the necessary permit
applications before the release can be issued.
Because of the time it may take for AQMD to go through the above procedures, the applicant is
advised to contact AQMD immediately after applying for building permits.
ADDITIONAL SUPPLEMENTAL INFORMATION I
i
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June 25, 1996
Cityof Huntington Beach
License Department
P.O. Box 711
2000 Main Street
Huntington Beach, CA 92648
Dear Sirs,
This letter is to inform you that as of around 1" of July 1996; Carl Karcher Enterprises Inc. will be taking
over own rship and operations of 1 Rally's Restaurant in the City of Huntingion Beach. Please list new
ownership -is follows:
Carl Karcher Enterprises Inc.
P.Q. Box 4349
Anaheim, CA 92803
Our corporation information consists of die following:
CA Resale ID # - SYEA 24-606441
State Employer ID # - 077-6758 5
Federal ID #-95-2415578
President - Charles T. Thompson
Listed below is the location, please use the Rally's and Store # as the DBA.
/ Rally's #690 - 10001 Adams Ave. - Huntington Beach, CA 92648
I
Thank • for all of your help. Please bill us for any License fees. If you have any questions please call
me at i � 4)-778-7116.
II ,
Sir :erely,
Iv,
Diane Huntoon
Senior Accounting Clerk
Carl Karcher Enterprises Inc.